Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elyse Renee Broucek

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1770180960

Elyse Renee Broucek is a Physician Assistant in Phoenix, Arizona. Qualified in 2020, 6 years ago. Practices with Alliance Dermatology and Mohs Center PC, a 10-clinician group, works from 3 locations and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4045 E Bell Rd Ste 125
Phoenix, AZ 85032-2238
Phone: (602) 971-0268
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 13843 W Meeker Blvd, Sun City West, AZ 85375-5285 — (623) 584-1325
  • 14506 W Granite Valley Dr Ste 220, Sun City West, AZ 85375-6013 — (623) 584-1325

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1770180960
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 1, 2020
Last updated in NPPESFebruary 4, 2025
Certification dateFebruary 4, 2025
Mailing address4045 E Bell Rd Ste 125, Phoenix, AZ 85032-2238

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Alliance Dermatology And Mohs Center Pc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Phoenix